HEALTHY ONLINE

The Patient Centered Medical Home (PCMH) model of care is built on seven principles. Seven is a lucky number in some cultures, but if you ever tried to stand something up on seven legs, you probably know that eight is better and sturdier. The medical home is missing a pillar, and strangely enough the missing pillar is the very reason why the concept was originally proposed. The seven principles of the PCMH were jointly formulated by the primary care medical societies in 2002 to describe the characteristics of a PCMH practice, and consist of a personal physician, physician directed medical practice, whole person orientation, coordinated and/or integrated care, quality and safety, enhanced access and appropriate payment. So what are we missing? Back in 1967, the American Academy of Pediatrics (AAP) introduced the term “medical home” realizing that fragmented and incomplete medical records are an impediment to proper care for children with chronic conditions: "For children with chr...

Approximately a quarter million clinicians and hospitals have signed up for Meaningful Use incentives to date . Of those, almost a hundred thousand have received over $5 billion in incentives. In addition to the registered providers, there are significant numbers of practicing physicians who do not qualify for incentives, due to payor mix or practice characteristics, and who are also buying and using EHRs. Perhaps this is a bit slower than the most optimistic projections, but the entire program seems to be forging ahead rather well, and EHR adoption is steadily increasing. The EHR incentive program is funded by taxpayer dollars to the tune of $30 billion, in the midst of a harsh recession, and is supposed to motivate our health care providers to purchase EHRs because according to the White House, the Secretary of Health and Human Services, the Centers for Medicare and Medicaid Services (CMS) and obviously the Office of the National Coordinator for Health Information Technology (ONC), E...

For almost three years now, since the advent of the HITECH Act, and prompted by the exorbitant prices of health care, an animated electronic medical records debate has been unfolding on a national stage. It seems that every possible or impossible solution to our health care woes is in some shape or form dependent on widespread use of computerized medical records. Computers have been utilized to change almost every industry, making products and services cheaper, more accessible and in some instances better, so the hope is that computers can do the same for health care services. There are three fundamental ways in which computerization of an industry is advantageous: process automation, improved information processing and better communications. Arguably, we can use all three in health care. Process automation need not be construed as referring to the processing of people, although it often is. Health care has plenty of processes that can and should be automated. The most ubiquitous autom...